Implementing Pharmacist-Led Patient Home Visits

K. McKeirnan, Kyle R Frazier, Beau Keown
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引用次数: 6

Abstract

Introduction Patients with chronic diseases such as hypertension and diabetes often experience difficulties managing complex medication regimens. A promising method for identifying and addressing medication-related problems is pharmacist provision of patient home visits. Pharmacist home visits could alleviate the burden on both patients and providers for the purposes of maintenance medication and goal-achievement assessment. Methods A pharmacist home visit program was developed utilizing social workers to identify patients who would most benefit from a pharmacist home visit. The two pharmacists met with these patients in their homes to evaluate their current medication regimens, adherence, medical condition status, and potential drug-related problems (DRPs). Upon conclusion of the home visit, the pharmacists provided a summary of findings and proposed solutions for identified drug related problems to the patient's primary care provider. Results Fourteen patients participated in pharmacist-provided home visits. During these home visits, 98 unique DRPs were identified. Drug-related problems were grouped into four categories: adherence (n=26, 27%), effectiveness (n=25, 26%), indication (n=24, 24%), and safety (n=23, 23%). Between the initial visit and the final visit, there was a resolution of 25 (26%) drug related problems. Conclusion This project demonstrated a novel referral pathway for identifying patients to participate in pharmacist-led home visits. By providing patient home visits, pharmacists were able to identify and resolve some drug-related problems, but many problems remain unresolved due, in large part, to lack of provider engagement.
实施药剂师主导的患者家访
引言患有高血压和糖尿病等慢性病的患者在管理复杂的药物治疗方案时经常会遇到困难。药剂师提供患者家访是识别和解决药物相关问题的一种很有前途的方法。药剂师家访可以减轻患者和提供者的负担,用于维持用药和目标实现评估。方法利用社会工作者制定药剂师家访计划,以确定哪些患者最能从药剂师家访中受益。两名药剂师在家中与这些患者会面,评估他们目前的用药方案、依从性、医疗状况和潜在的药物相关问题(DRP)。家访结束后,药剂师向患者的初级保健提供者提供了调查结果摘要和已发现的药物相关问题的建议解决方案。结果14名患者参加了药剂师提供的家访。在这些家访中,发现了98个独特的DRP。药物相关问题分为四类:依从性(n=26,27%)、有效性(n=25,26%)、适应症(n=24,24%)和安全性(n=23,23%)。从初次就诊到最后一次就诊,有25个(26%)药物相关问题得到了解决。结论该项目为确定患者参与药剂师主导的家访提供了一种新的转诊途径。通过提供患者家访,药剂师能够发现并解决一些与药物有关的问题,但许多问题仍未解决,这在很大程度上是由于缺乏提供者的参与。
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